Biomedical subjects

D Nashan

Publications and source records attributed to D Nashan.

39 records · Page 3Linked to original sources

PubMedDate not supplied

Epididymal markers in human infertility.

Alpha-glucosidase, glycerophosphocholine, and L-carnitine were measured in sperm-free seminal plasma to determine whether these markers reflected the epididymal function of men attending an infertility clinic. The putative markers correlated well with each other (r = 0.66 to 0.70) and in 92% of 283 cases were accurate in categorizing semen as containing normal or subnormal amounts of markers. Glucosidase was considered the best index of epididymal function and was used for a further 306 samples. The ejaculate content of epididymal markers was correlated with testicular volume and serum testosterone below values of 30 ml and 30 nmol/l, respectively. Markers were also correlated with the concentration and motility of spermatozoa in semen. Seventy-one of 425 patients (17%) displayed subnormal epididymal secretions, mainly in association with hypogonadism (Klinefelter syndrome, Kallman syndrome, idiopathic hypogonadotropic hypogonadism) but also in cases of obstructed ducts, maldescended testicles, and local irradiation following hemicastration. Because azoospermic patients had reduced epididymal markers with both high and low FSH levels and a large proportion of men with reduced glucosidase and normal FSH suffered from testicular failure, it is suggested that other indices of testicular function are required for correct interpretation of reduced epididymal markers. Thirteen patients (3%) had low markers for which no cause was apparent; these may be cases of infertility due to isolated epididymal dysfunction.

Adult↗

PubMedDate not supplied

Diagnostic value of scrotal sonography in infertile men: report on 658 cases.

Scrotal sonography with a 7.5 MHz sector scanner was performed on 658 consecutive patients of our infertility clinic. The incidence of pathological findings was unexpectedly high. Forty per cent of the patients revealed pathological structures such as varicoceles (21%), hydroceles (7%), epididymal abnormalities (6%), spermatoceles (6%), intratesticular hyper- and hypoechoic changes (4.5%), intratesticular cysts (1%) and tumours or carcinoma in situ (CIS) (0.6%). Sonographic evaluation and measurement of the caput epididymidis was compared with palpation. Sonography distinguished size ranges of "normal" and "thickened" epididymides as diagnosed by palpation. Cystic structures were proven in 56% of cases with "thickened" epididymides. The sonographically determined diameters of doppler-negative blood vessels were significantly smaller than those of doppler-positive vessels. Sonography revealed a higher occurrence of varicoceles than diagnosed by palpation (76% by palpation). Only 58% of sonographically identified hydroceles and only 67% of sonographically detected spermatoceles were detected by palpation. One testicular tumour and one case with CIS were only seen by sonography and not suspected on palpation. The results demonstrate that sonography represents a valuable tool in the routine diagnosis of andrological patients.

Adult↗

PubMedDate not supplied

Surgical ligation vs. angiographic embolization of the vena spermatica: a prospective randomized study for the treatment of varicocele-related infertility.

Varicoceles as a common cause of male infertility are treated either by surgical ligation or, more recently, by angiographic occlusion of the spermatic vein. In the present prospective randomized study 38 patients were treated by surgical ligation and 33 by angiographic embolization. During the 12-month follow-up period a significant increase in sperm number (at 3 and 12 months) and sperm motility (at 12 months) occurred in both groups while sperm morphology remained unaffected. Altogether, 22 pregnancies (31%) were reported within the year following treatment, of which 11/38 (29%) occurred in the ligation group and 11/33 (33%) in the embolization group. Thus both treatment modalities appear equivalent, whereby embolization has the advantage that it can be performed on an outpatient basis.

Adult↗